Spine
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Randomized Controlled Trial Multicenter Study
Cost-utility analysis of physiotherapy treatment compared with physiotherapy advice in low back pain.
Economic evaluation alongside a pragmatic multicenter randomized controlled trial from the National Health Service (NHS) and societal perspective. ⋯ The results indicate no significant differences in either NHS costs or effects. However, the significantly higher out-of-pocket expenses incurred by patients receiving routine physiotherapy suggests that advice given by a physiotherapist should be considered as the first-line treatment for patients with this level of back pain disability.
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Multicenter Study
Validation of a minimum outcome core set in the evaluation of patients with back pain.
Prospective study of patients with subacute osteoporotic fracture (SOF) or chronic low back pain (CLBP). ⋯ These findings support the potential usefulness of the Core Set when respondent burden is a major concern. However, subscale scores need to be further tested in other populations before they can be widely recommended.
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Randomized Controlled Trial Multicenter Study Comparative Study
Revisability of the CHARITE artificial disc replacement: analysis of 688 patients enrolled in the U.S. IDE study of the CHARITE Artificial Disc.
A prospective, randomized, multicenter, FDA-regulated Investigational Device Exemption clinical trial. ⋯ Lumbar TDR with the CHARITE Artificial Disc did not preclude any further procedures at the index level during primary insertion, with nearly one third being revisable to a new motion-preserving prosthesis and just over two thirds being successfully converted to ALIF and/ or posterior pedicle screw arthrodesis, the original alternative procedure.
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Multicenter Study Comparative Study
Can condition-specific health surveys be specific to spine disease? An analysis of the effect of comorbidities on baseline condition-specific and general health survey scores.
This is an observational cross-sectional study of 26,290 patients seen and evaluated in the 25 centers of the National Spine Network. ⋯ Traditional medical comorbidities correlate with both SF-36 (e.g., PCS) general health survey scores as well as disease-specific ODI scores. However, psychosocial comorbidities such as poor self-rated health (SF-1), an active compensation case, and low education level have a higher association than traditional medical comorbidities on these health status measures. The results show that the type of survey (disease-specific e.g., ODI, vs. generic e.g., SF-36) used may be less important than the need to assess and control for psychosocial and medical comorbidities when any patient-reported health survey is used in the spine population.
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Multicenter Study
Reliability of a novel classification system for thoracolumbar injuries: the Thoracolumbar Injury Severity Score.
Prospective study of 5 spine surgeons rating 71 clinical cases of thoracolumbar spinal injuries using the Thoracolumbar Injury Severity Score (TLISS) and then re-rating the cases in a different order 1 month later. ⋯ The TLISS has good reliability and compares favorably to other contemporary thoracolumbar fracture classification systems.